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Prolonged duration of post-traumatic amnesia: A sensitive classification for predicting cognitive outcomes in

Shira Segev1, Tamar Silberg1,2, Orly Bar3

  • 1Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel.

Journal of the International Neuropsychological Society : JINS
|February 13, 2023
PubMed

Insights

Longer post-traumatic amnesia (PTA) in children with moderate-severe traumatic brain injury (msTBI) predicts poorer attention and executive function. Shorter PTA durations correlate with better cognitive outcomes in pediatric TBI recovery.

Area of Science:

  • Pediatric Neuropsychology
  • Traumatic Brain Injury Research
  • Cognitive Rehabilitation

Background:

  • Limited data exists on post-traumatic amnesia (PTA) duration as a predictor of cognitive function in pediatric traumatic brain injury (TBI).
  • Understanding this relationship is crucial for effective sub-acute recovery and rehabilitation strategies in children with moderate-severe TBI (msTBI).

Purpose of the Study:

  • To investigate the association between PTA duration and neurocognitive functioning in children with msTBI during the sub-acute recovery phase.
  • To determine if PTA duration can predict higher-order cognitive abilities such as attention and executive function.

Main Methods:

  • Retrospective analysis of 103 children (aged 5.5-16.5) with msTBI hospitalized between 2004-2019.
  • PTA duration assessed using the Children Orientation and Amnesia Test.
  • Attention and executive function measured with the Test of Everyday Attention-Child version (TEA-Ch).

Main Results:

  • Cluster analysis identified three PTA groups: "Long PTA" (21 days), "Very Long PTA" (47 days), and "Extremely Long PTA" (94 days).
  • Children in the "Long PTA" group demonstrated significantly better performance on all TEA-Ch measures (Selective Attention, Attentional Control Switching, Sustained Attention) compared to the "Very Long PTA" and "Extremely Long PTA" groups.

Conclusions:

  • PTA duration is a significant predictor of higher-order cognitive functions in pediatric msTBI patients during sub-acute recovery.
  • A refined classification of prolonged PTA durations can enhance outcome prediction and resource allocation for children with severe brain injuries.
Abstract

Keywords:
acquired brain injuryattentioncognitive assessmentexecutive functionpediatricspost-traumatic amnesia (PTA)

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